Active NPI
Kristin Carolan
- Marriage & Family Therapist
- Naples, FL
National Provider Identifier
1093110033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMT1453
- Practice address
- 5867 Whitaker Rd
Naples, FL 34112-2963 - Phone
- (239) 774-2904
- Fax
- (239) 774-1438
- NPI assigned
- Nov 4, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMT1453 | FL | Primary |
Addresses
Primary practice location
5867 Whitaker Rd
Naples, FL 34112-2963
Mailing address
5867 Whitaker Rd
Naples, FL 34112-2963
Phone (239) 774-2904
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000944600 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMT1453 | FL | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth Haven Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Naples, FL
- NPI 1740452283
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415059200000",
"number": "1093110033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5867 WHITAKER RD",
"city": "NAPLES",
"state": "FL",
"postal_code": "341122963",
"telephone_number": "239-774-2904",
"fax_number": "239-774-1438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5867 WHITAKER RD",
"city": "NAPLES",
"state": "FL",
"postal_code": "341122963",
"telephone_number": "239-774-2904",
"fax_number": "239-774-1438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAROLAN",
"first_name": "KRISTIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-04",
"last_updated": "2014-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "IMT1453",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000944600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Naples, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.